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(Circulation Research. 2005;96:1022.)
© 2005 American Heart Association, Inc.

Clinical Research

Reprogramming of the Human Atrial Transcriptome in Permanent Atrial Fibrillation

Expression of a Ventricular-Like Genomic Signature

Andreas S. Barth, Sylvia Merk, Elisabeth Arnoldi, Ludwig Zwermann, Patrick Kloos, Mathias Gebauer, Klaus Steinmeyer, Markus Bleich, Stefan Kääb, Martin Hinterseer, Heike Kartmann, Eckart Kreuzer, Martin Dugas, Gerhard Steinbeck, Michael Nabauer

From the Departments of Medicine I (A.S.B., E.A., L.Z., P.K., S.K., M.H., H.K., G.S., M.N.) and Cardiac Surgery (E.K.), University Hospital Grosshadern, and the Department of Medical Informatics, Biometrics, and Epidemiology (S.M., M.D.), Ludwig-Maximilians-University, Munich, Germany; Aventis Pharma Deutschland GmbH (M.G., K.S., M.B.), Frankfurt am Main, Germany; and the Institute of Physiology (M.B.), Christian- Albrechts-University, Kiel, Germany.

Correspondence to Dr med Andreas S. Barth, Department of Medicine I, University Hospital Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany. E-mail andreas.barth{at}med.uni-muenchen.de

Atrial fibrillation is associated with increased expression of ventricular myosin isoforms in atrial myocardium, regarded as part of a dedifferentiation process. Whether reexpression of ventricular isoforms in atrial fibrillation is restricted to transcripts encoding for contractile proteins is unknown. Therefore, this study compares atrial mRNA expression in patients with permanent atrial fibrillation to atrial mRNA expression in patients with sinus rhythm and to ventricular gene expression using Affymetrix U133 arrays. In atrial myocardium, we identified 1434 genes deregulated in atrial fibrillation, the majority of which, including key elements of calcium-dependent signaling pathways, displayed downregulation. Functional classification based on Gene Ontology provided the specific gene sets of the interdependent processes of structural, contractile, and electrophysiological remodeling. In addition, we demonstrate for the first time a prominent upregulation of transcripts involved in metabolic activities, suggesting an adaptive response to increased metabolic demand in fibrillating atrial myocardium. Ventricular-predominant genes were 5 times more likely to be upregulated in atrial fibrillation (174 genes upregulated, 35 genes downregulated), whereas atrial-specific transcripts were predominantly downregulated (56 genes upregulated, 564 genes downregulated). Overall, in fibrillating atrial myocardium, functional classes of genes characteristic of ventricular myocardium were found to be upregulated (eg, metabolic processes), whereas functional classes predominantly expressed in atrial myocardium were downregulated (eg, signal transduction and cell communication). Therefore, dedifferentiation with adoption of a ventricular-like signature is a general feature of the fibrillating atrium.

Key Words: atrial fibrillation • gene expression • atrial myocardium • functional genomics

Related Article:

Ventricularization of Atrial Gene Expression in the Fibrillating Heart?

Gordon F. Tomaselli
Circ. Res. 2005 96: 923-924. [Full Text] [PDF]

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